Hampshire HOPE: In a pandemic, many areas of concern for people facing substance use disorders


For the Gazette
Published: 3/26/2020 3:18:05 PM

“I know this is an incredibly stressful and dizzying and overwhelming time — we’re in a healthcare crisis the likes of which we haven’t seen in our lifetimes. While this pandemic is upon us, it lies on top of a substance abuse epidemic that we have been managing for the last 10 years.”

These are the words of Dr. Ruth Potee, medical director for addiction services at Behavioral Health Network, speaking on a telephone conference call hosted by the Opioid Task Force of Franklin County and the North Quabbin on March 17 to address the impact of the coronavirus crisis on people dealing with substance use disorders.

Around 50 people from Hampshire and Franklin counties, including many members of the Hampshire HOPE opioid prevention coalition attended this phone-in meeting. All callers work in some way with people who use drugs, people struggling with addictions, people in recovery, and their families and loved ones.

That was one of three virtual meetings I joined last week on the topic of the coronavirus crisis and how it disproportionately impacts some of the most vulnerable people.

Another one was a Zoom meeting convened by Hampshire HOPE. Participants on the Opioid Task Force call and the HOPE meeting spent a great deal of time discussing the needs of people living with addiction issues in the middle of this public health crisis.

“We have a lot to consider here. We know that people with substance use disorder may potentially have other chronic diseases which puts them at greater risk for COVID-19,” said Hampshire HOPE Coalition Coordinator J. Cherry Sullivan, at the start of the Zoom discussion.

Sullivan noted that she harbors particular concerns about community members who are, as she put it, “sleeping rough” or couch surfing; people who don’t have transportation to appointments; and people who suddenly lose access to clinical and social support necessary to stay safe.

In light of those concerns, what follows are a few of the issues to consider:

RECOVERY SUPPORT: “We know that the opposite of addiction is connection,” Potee said on the Opioid Task Force call.

That’s why the isolation resulting from the social distancing required in the face of a global outbreak heightens concerns about those who use drugs, people struggling with addiction to any substance and those in long term recovery.

Many 12-Step and other peer recovery support meetings held in church basements across the region have been canceled indefinitely as religious institutions heed the call for social distancing to contain the spread of the virus.

People in recovery are urged to try online meetings if possible. Here are links to information about online recovery support meetings:

Alcoholics Anonymous telephone meetings:https://aa-intergroup.org/directory_telephone.php

Alcoholics Anonymous online meetings:http://aa-intergroup.org/directory.php

In person Learn to Cope support meetings for families of people struggling with opioid use disorders are canceled, but the website offers phone help and instructions about private online peer discussion boards: https://www.learn2cope.org/

Narcotics Anonymous:https://virtual-na.org/

Smart Recovery:https://www.smartrecovery.org/smart-recovery-toolbox/smart-recovery-online/

Recovery Dharma:https://recoverydharma.online/


In the Rooms:https://www.intherooms.com/home/category/community-and-meetings/

And while options for online recovery meetings are available, it’s also true that not all people who need those meetings have Internet access. When attending in person meetings, these guidelines are recommended:

■Don’t go if you are sick or have been exposed to the virus;

■Check the meeting status before going because many have been canceled or moved elsewhere; wash hands thoroughly before and after meetings;

■End food sharing;

■Stop meeting rituals that include holding hands;

■If passing a donations basket, use gloves or leave basket in a place where people can drop money into it;

■Stop the ritual of passing literature around to take turns reading aloud.

Northampton Recovery Center (NRC) Director Lynn Ferro said the NRC has implemented policies to keep the center open, reducing in-person support to two all-recovery meetings each day at 11 a.m. and 2 p.m. There are no shared snacks. Ten people are allowed at each meeting with chairs set up six feet apart, sanitized before and after each meeting. Participants are asked to wash hands upon entering and are not allowed to move the chairs.

“We are pretty rigid about that,” said Ferro. “People are happy that we are holding meetings.”

In addition, all NRC recovery coaching is taking place by telephone, rather than in person, according to Ferro and NRC staff are available for telephone calls as well.

DART PROGRAM: Hampshire HOPE’S Drug Addiction Response Teams (DART) are still responding, aiming to provide naloxone kits to anyone who asks. DART teams are using the phone and other technology to provide harm reduction information, recovery coaching and other support. The DART line is (413)-588-2335 for phone calls and texts to help connect people to services.

MEDICATION-ASSISTED TREATMENT: Potee recommends that people should request — and physicians should grant — 90 day supplies of medication when possible.

In addition, some regulations have been loosened so that people receiving medication-assisted treatment for opioid use disorder are now allowed to have medication-assisted treatment visits by telephone or video conferencing when clinically appropriate and when possible, the length of medication-assisted treatment prescriptions should be extended.

The federal Substance Abuse and Mental Health Services Administration known as SAMHSA announced this week that opioid treatment programs in states with declared states of emergency (such as Massachusetts) may give stable patients 28 days of take-home doses of the opioid use disorder medication and 14 days for clients who are less stable but who providers believe can safely handle that amount of take-home medication.

Because these practices will lead to a need for increased medication supply, SAMHSA urges care providers to make sure enough medication ison hand to meet patient needs.

For provider information issued by SAMHSA, visit https://www.samhsa.gov/sites/default/files/covid-19-42-cfr-part-2-guidance-03192020.pdf

HARM REDUCTION: Liz Whynott, director of harm reduction programs at Tapestry Health says harm reduction sites are open, but services focused on even more widely distributing the overdose reversal drug naloxone as well as safer injection supplies such as new needles. Community education events about naloxone and HIV testing services have been put on hold.

“It is a priority for us to make sure Narcan gets into the hands of people who need it,” she said.

For more information related to harm reduction in the face of the coronavirus crisis, check out this special section of the Harm Reduction Coalition website: https://harmreduction.org/miscellaneous/covid-19-guidance-for-people-who-use-drugs-and-harm-reduction-programs/

Another concern among those who work in harm reduction is for people who are dependent on alcohol if a broader shutdown leads to the closing of package stores.

“I’m very worried about people with an alcohol dependence and going through withdrawal from that because that can be very dangerous,” said Whynott.

In that case, people would be urged to go to an emergency department, as alcohol withdrawal can be life threatening.

When it comes to a public health catastrophe like the one we are facing now, many sub-groups of vulnerable people will be disproportionately hurt by the impact of the virus and the disease it causes.

Sullivan believes that multisector coalitions like Hampshire HOPE and the Opioid Task Force can work together to save lives among the populations that tend to be both overlooked and disproportionately affected.

The meetings held last week were only a start, bringing creative minds and compassionate hearts together to address the complexity of issues we face.

It’s reassuring to know that there are people ready to think long and hard so that as this pandemic unfolds, we might flatten the curve for that population as well.

Laurie Loisel is director of community outreach and education at the Northwestern District Attorney’s office, which is part of the Hampshire HOPE opioid prevention coalition run out of the city of Northampton’s Health Department. Hampshire HOPE members contribute to this monthly column about local efforts addressing the opioid epidemic.

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